First magnetic navigation catheter intervention in child

Ten-year-old Tobias smiles brightly at the photographer. And so do the two physicians next to him. They have good reason to be proud as they were the first surgeons worldwide to treat a very serious congenital heart defect in a child by guiding a catheter with the help of a magnetic navigation system into small lung vessels.

Tobias feels better since the magnetic navigated intervention.
Tobias feels better since the magnetic navigated intervention.
Pulmonary atresia with ventricular septal defect (PA-VSD) means that no pulmonary artery exists and the left and right pulmonary valves are blocked. Newborn children with such a defect can only survive because the body develops extra blood vessels, so-called collaterals, to provide the lungs with some, albeit insufficient, perfusion. In Tobias’ case, moreover, the blood flow in the collaterals was disturbed by stenoses. Due to the reduced oxygen uptake it was difficult for Tobias to walk even short distances.
PA-VSD has to be treated surgically. Tobias’ heart failure, however, was so complicated that a planned surgical intervention by an international team had to be called-off. Therefore, the cardiologists, Dr Nikoloaus Haas from the hospital for congenital heart defects and Prof Deniz Kececioglu, director of the clinic of thoracic and cardiovascular surgery of the Rhein-Ruhr University Bochum, Germany, decided to repair and support the collaterals with stents using magnetic navigation. It was worldwide the first time the procedure was undertaken in a child.
Magnetic navigation allows the surgeon to catheterize vessels that are difficult to access. Small magnets are integrated in the tip of the catheter’s guiding wire and magnetic fields are created to the right and to the left of the patient. A remote-control navigation system guides the catheter through the body with the surgeon following the catheter on a real-time x-ray image. Thus, even the smallest and meandering vessels in Tobias’ lungs could be accessed, expanded and supported with stents.
Only a few hours after this invention Tobias felt better. The oxygen concentration in his blood increased and perfusion had clearly improved. Two days later the boy walked out of the hospital. The physicians enjoyed Tobias’ physical progress as much as he did himself. “The new technique will help patients who were considered untreatable in the past”, Haas said.


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